Pathophysiology of meningioma growth in pregnancy

Hortobágyi, Tibor; Bencze, János; Murnyák, Balázs; Kouhsari, Mahan C.; Bognár, László; Markó-Varga, György

doi:10.1515/med-2017-0029

Cited by 49 publications

(65 citation statements)

References 37 publications

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“…In this study, the most common histological type of tumor was meningioma (19.5%, eight cases). This may be related to the fact that meningiomas are known to express progesterone receptors, which lead to increased symptom severity during pregnancy [41]. The histological types of brain tumors are diverse [38], and in this study, we found a great variety of histological types not necessarily specific to pregnancy, which is in accordance with previous reports [37,42].…”

Section: Discussionsupporting

confidence: 92%

Management Strategies for Brain Tumors Diagnosed during Pregnancy: A Case Report and Literature Review

et al. 2021

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Background and Objectives: Maternal brain tumors diagnosed during pregnancy are very rare, and their clinical course remains incompletely understood. We recently experienced a case of a brain tumor diagnosed at 30 weeks of gestation, and the treatment was initiated after delivery at 32 weeks of gestation. In this study, we reviewed case reports of brain tumors diagnosed during pregnancy, focusing on whether the brain tumor was treated during pregnancy or after termination of pregnancy and on the timing of therapeutic intervention. Materials and Methods: We searched PubMed and Ichushi-Web for articles published after January 2000 that reported cases of maternal brain tumors diagnosed during pregnancy. The patients were divided into two groups according to whether the tumor was treated during pregnancy (Group A) or after termination of pregnancy (Group B). Results: In total, 42 patients were included in the study (13 (31%) in Group A and 29 (69%) in Group B). The most common symptoms before diagnosis were those caused by increased intracranial pressure (57.1%). The diagnosis was made at 18 ± 6 weeks of gestation in Group A and 26 ± 9 weeks of gestation in Group B (p = 0.007). In all cases diagnosed after 34 weeks of gestation, termination of pregnancy was followed by treatment. Treatment was initiated within two weeks of diagnosis in 50% of patients in Group A and 30% in Group B. Conclusions: When severe symptoms caused by increased intracranial pressure last for several weeks, imaging tests should be considered. Termination of pregnancy is a good option for a brain tumor diagnosed after 34 weeks of gestation, while comprehensive treatment decisions should be made based on the severity of symptoms and the course of pregnancy in other cases.

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Section: Discussionsupporting

confidence: 92%

Management Strategies for Brain Tumors Diagnosed during Pregnancy: A Case Report and Literature Review

et al. 2021

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“…Although a typically slow-growing tumour, a meningioma can have accelerated growth in pregnancy because of increasing oestrogen and progesterone levels and vascular endothelial growth factors. 19 The incidence of meningiomas during pregnancy is estimated at 5.6 cases in 100,000 pregnant women. 20 A pre-existing sphenoid bone meningioma near the optic canal can result in compressive optic neuropathy.…”

Section: Meningiomamentioning

confidence: 99%

Ophthalmic associations in pregnancy

Qin¹,

Chen²,

Cugati³

2020

Aust J Gen Pract

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Background A range of ocular pathology exists during pregnancy. Some pre-existing eye conditions, such as diabetic retinopathy, can be exacerbated during pregnancy. Other conditions manifest for the first time during pregnancy as a result of complications such as pre-eclampsia and eclampsia. Early recognition and understanding of the management of ophthalmic conditions is crucial. Objective The aim of this article is to discuss the physiological and pathological changes in the eyes of pregnant women. Pathological changes are subdivided into: 1) pre-existing eye conditions modified during pregnancy, 2) pathological conditions occurring for the first time and 3) ophthalmic associations due to complications in pregnancy. Discussion This article reviews the ophthalmic conditions that can manifest during pregnancy and discusses their pathophysiology and clinical implications. Recognition, history and examination of ophthalmic conditions and a diagnostic framework for referral are provided. Fundamental multidisciplinary care principles involving the primary care physician, ophthalmologist, rheumatologist or haematologist and obstetrician in the care of the pregnant patient are discussed.

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“…[21][22][23][24] On the other hand, vascular changes, possibly related to the expression of VEGF, have been shown to be an additional causative mechanism for growth of meningiomas during pregnancy. 25,26 Also, the expression of other growth factor receptors, such as FGF-R and PDGF-Rβ, may be involved. 27 For orbital schwannoma it is unclear what may cause excessive growth during pregnancy and little is known about receptor expression of these tumors.…”

Section: Discussionmentioning

confidence: 99%

Accelerated growth of orbital schwannomas during pregnancy does not correlate with sex hormone- or growth factor receptor status

Hötte

Meijer

Verdijk

et al. 2020

Orbit

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Purpose: Until now, three cases of growth of an orbital schwannoma during pregnancy have been published. We aim to provide additional insight in the effect of pregnancy on orbital schwannomas. Methods: We present two additional cases of accelerated growth of orbital schwannomas during pregnancy and investigate receptor expression profiles for estrogen, progesterone, androgen, VEGF, EGF, FGF, PDGF-Rβ and ki-67 in the two pregnant cases and six non-pregnant cases. Results: Case 1: A 26-year-old woman developed unilateral exophthalmos during pregnancy, with normal visual acuity and ocular motility. During a subsequent pregnancy, again the exophthalmos progressed. MRI showed a mass suggestive of schwannoma. After delivery, resection of the lesion was performed through an anterior approach. Pathology confirmed schwannoma. The expression profile was positive for estrogen-and FGF receptors and ki-67, but negative for progesterone-, androgen-and other growth factor receptors. Case 2: A 24-year-old woman presented with diplopia and unilateral pain during pregnancy. She had normal visual acuity, but a mild exophthalmos and elevation deficit. MRI revealed an extraconal mass suggestive of schwannoma. After delivery, resection was performed through an anterior approach. Pathology confirmed the diagnosis. The expression profile was positive for ki-67, but negative for sex hormone-and growth factor receptors. In the six non-pregnant cases the expression profiles varied, with only one subject showing a strong expression of estrogen-, progesterone-and androgen receptors. Conclusions: Orbital schwannomas can experience growth during pregnancy. The underlying mechanism remains unclear as hormone-and growth factor expression profiles show no correlation to the pregnant state.

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Pathophysiology of meningioma growth in pregnancy

Cited by 49 publications

References 37 publications

Management Strategies for Brain Tumors Diagnosed during Pregnancy: A Case Report and Literature Review

Management Strategies for Brain Tumors Diagnosed during Pregnancy: A Case Report and Literature Review

Ophthalmic associations in pregnancy

Accelerated growth of orbital schwannomas during pregnancy does not correlate with sex hormone- or growth factor receptor status

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